I am having an argument with one of our ins payers right now about add-on codes. We use this code for our breast reconstructions and they are bilateral procedures. I thought that add-on codes were not subject to multiple procedure or 150% bilateral reductions. All of our payers pay these at 100% of allowable on both the right and left side even Medicare. The MPFS shows that this IS subject to the 150% bilateral reductions, but even our Medicare claims are paying at 100% for both sides. Please help me settle this argument one way or another.
Thanks!!
Thanks!!